颈动脉狭窄TCD、颈动脉超声、CTA诊断价值探讨

Diagnostic value of transcranial Dopple,carotid ultrasound/CTA for stenosis of carotid artery

目的:分析比较经颅多普勒(TCD)、颈动脉超声检查、多层面螺旋CT血管成像(CTA)对颈动脉狭窄、闭塞的诊断价值及其在缺血性脑血管病二级预防中的意义。方法:收集790例缺血性脑血管病病例资料,均行TCD检查,将其中经颈动脉超声检查200例、CTA检查26例,诊断为颈动脉狭窄的影像检查结果与TCD检查结果作比较分析。结果:⑴790例患者中,TCD检出提示为血管狭窄异常人数为570例,阳性率为72.2%;⑵与颈动脉超声检查比较,TCD对颈动脉中重度以上狭窄的检查阳性率为79%;⑶与CTA检查比较,TCD诊断颈动脉狭窄的阳性检出率为75%,特异性为100%。结论:TCD对颅外段ICA中、重度狭窄、闭塞的患者具有较好的敏感性和特异性,在缺血性脑血管病二级预防中可作为首选筛查方法,颈动脉超声和CTA是明确诊断合适的后续方法。

Objective： Analysis and Comparison of the diagnostic values of transcranial Doppler（TCD）,carotid artery ultrasonography,multi-slice CT angiography（CTA） in the carotid artery stenosis,occlusion and their significance in secondary prevention of ischemic cerebrovascular disease.Methods： All carotid arteries of 790 patients outpatient/hospitalized with ischemic cerebrovascular diseases were examined with TCD,among them,200 cases were examined by color ultrasonography and 26 cases were examined by CTA..The results of TCD with those of Color Dopple ultrasonography or CTA were compared.Results：（1） In 790 cases,570 cases（72.2%） with abnormal vascular were examined by TCD.200 cases with senosis carotid artery were diagnosised by ultrasonography.（2） Compared with carotid ultrasound,the positive rate of TCD in moderate,severe stenosis and occlusion of carotid artery is 79%.（3）26 cases were examined by CTA,The sensitivity and specificity of TCD for stenosis of carotidrartery were 75% and 100%.Conclusion： TCD has relative diagnostic value in moderate,severe stenosis and occlusion of carotid artery.It can be as first screen examination in second level prevention of ischemic cerebralvascular disease,carotid ultrasound,and CTA are the appropriate follow-up method of clear diagnosis.